Lecture 8: Thought Disorders

Question 1

schizophrenia vs. psychosis

Answer 1

psychosis: broad term referring to hallucinations and/or delusions
schizophrenia: a type of psychosis with disturbed thought, language, and behaviour. Lasts for at least 6 months.

Question 2

Positive symptoms of schizophrenia

Answer 2

delusions: a belief that would be seen by most members of society as a misrepresentation of reality
- the basic characteristic of madness
hallucinations: hearing a voice or seeing something that is there.. feels very real and can be regular
- sensory events without any input from the surrounding environment (most commonly auditory)

Question 3

Negative symptoms

Answer 3

• diminished emotional expression and avolition
• avolition: inability to initiate and persist in activities (apathy)
• alogia: relative absense of speech
• anhedonia: indifference to activities that would typically be considered pleasurable
• affective flattening: flat or blunted affect

Question 4

Disorganized Symptoms of schizophrenia

Answer 4

• disorganized speech
• difficult to elicit relevant information
• lack insights
• cognitive slippage
• tangentiality: never really answering the question
• inappropriate affect and disorganized behaviour:
• may laugh or cry at inappropriate times
• catatonia

Question 5

Schizophrenia Subtypes

Answer 5

1. paranoid type
2. disorganized type
3. catatonic type
4. undifferentiated type
5. residual type

Question 6

Paranoid Type

Answer 6

• distinguished by delusions/hallucinations
• usually there is a theme to their grandeur/persecution
• cognitive skills relatively intact
• better prognosis that other types of this illness

Question 7

Disorganized Type

Answer 7

• marked disruption in speech/behaviour
• flat inappropriate affect
• unusually self-absorbed
• if delusion/hallucinations, tend not to be thematic
• problems appear earlier, more chronic, lack remissions

Question 8

Catatonic Type

Answer 8

• sometimes odd mannerisms with their body/face
• unusual motor responses
• may include echolalia (repeating words) or echopraxia (movements)

Question 9

Undifferentiated Type

Answer 9

• do not fit neatly into other subtypes
• do not meet criteria for other types

Question 10

Residual Type

Answer 10

• have had at least one episode but no longer manifest major symptoms
• may display leftover symptoms
• social withdrawal, bizarre thoughts, inactivity, flat affect

Question 11

Brief Psychotic Disorder

Answer 11

• characterized by the presence of one or more positive symptoms within a month
• regain previous ability to function well in day to day activities
• often precipitated by an extremely stressful situations or event

Question 12

Shared Psychotic Disorder (Folie a Deux)

Answer 12

• an individual develops delusions simply as a result of a close relationship with a delusion individual

Question 13

schizophrenia onset and prevalence

Answer 13

• 0.3-0.7%
• usually develops in early adulthood, but can emerge at anytime
• affects males and females equally
• usually chronic

Question 14

Medical Treatment of Schizophrenia

Answer 14

antipsychotic (neuroleptic) medications
- medication treatment is often the first line treatment
- began in 1950s
- most reduce or eliminate the positive symptoms of schizophrenia
- acute and permanent extrapyramidal and parkinson-like side effects are common
- compliance with medication is often a problem

Question 15

Psychosocial Interventions of Schizophrenia

Answer 15

• behavioural on inpatient units
• community care programs
• social and living skills training
• behavioural family therapy
• vocational rehabilitation